Sepsis cost Medicare more than $6 billion in 2015, which is more than any other inpatient discharge, reported Modern Healthcare.
Sepsis, which is a life-threatening response to an infection that can lead to tissue damage, organ failure and death, kills about 250,000 people in the U.S. annually and is a leading cause of death for intensive care unit patients.
Before this new data, joint replacements topped the list as most common and costly inpatient discharge, but the CMS said sepsis payments are up, while joint replacements are down. One reason for joint replacements’ cost declines is medical and care improvements.
September is Sepsis Awareness Month, which makes Medicare's data release that more timely. This is the first year it's led the inpatient cost list for Medicare.
Payers and health systems are aware of the associated costs of sepsis in terms of hospitalizations and readmissions. Some hospitals have been able to reduce admissions rates for sepsis, but it’s not working across the healthcare system.
Sepsis readmissions may play an even bigger financial role for hospitals in the coming years. The CMS began penalizing hospitals for some sepsis readmission through the Hospital Readmissions Reduction Program this year and payers are offering value-based contracts incentivizing hospitals from preventing sepsis-related readmissions.
Not only is sepsis the most costly inpatient discharge for Medicare, a JAMA study earlier this year found that sepsis is a leading cause of readmissions among conditions tracked by CMS in 30-day readmission rates. The study found sepsis accounted for 12.2% of more than 1.1 million readmissions included in the 2013 Nationwide Readmissions Database. Another common readmission cause was heart failure at slightly less than 7%. The study authors also said the length of stay for sepsis readmissions is longer than other conditions, including heart failure, acute myocardial infarction and chronic obstructive pulmonary disease.